Abstract
Patients with Chronic Kidney Disease on Dialysis (CDRD) have a major risk of developing cancer when compared with the general population [1], thyroid carcinoma being the most common in the first group of patients [2]. The definitive treatment is thyroidectomy, but in patients at risk of recurrence ablative therapy with radioactive iodine I-131 is necessary [2]. We present the clinical case of a 61-year-old patient on hemodialysis with a slow growing anterior cervical tumor studied for more than two years until the diagnosis of papillary thyroid carcinoma. Initially the patient received surgical treatment and is currently awaiting treatment with radioactive iodine I-131.
Highlights
We present the clinical case of a 62-year-old male who attended the hospital emergency department in September 2008 because of hypertensive crisis, found to have advanced chronic kidney disease and started hemodiaysis via Central Venous Catheter (CVC)
Patients with chronic kidney disease on dialysis (CKD) have a higher risk of cancer when compared to the general population [1] and in the case of thyroid carcinoma its frequency is higher in the former group of patients [2]
A recent study in a haemodialysis population found that the mean time between initiation of haemodialysis and diagnosis of cancer was 64.40 ± 41.81months and the risk factors significantly related to its appearance were: advanced age, male sex and liver disease [3]
Summary
We present the clinical case of a 62-year-old male who attended the hospital emergency department in September 2008 because of hypertensive crisis, found to have advanced chronic kidney disease and started hemodiaysis via Central Venous Catheter (CVC). He was born in Mauritania and had a language barrier. From the start of hemodiaysis, he was diagnosed with secondary hyperparathyroidism, as well as multiple vascular access problems involving the placement of multiple central venous catheters He had several episodes of bacteraemia with bacterial endocarditis on the tricuspid valve and thrombosis of the superior and inferior vena cava, requiring angioplasty and stenting at both levels. In September 2017, on physical examination, a cervical tumour of firm consistency was detected in the left inferolateral and anterior region of the neck, associated with signs of venous hypertension in the left upper extremity (LUE) (Figure 1) where he had an immature humerus-cephalic Arterio-Venous Fistula (AVF) and a CVC in the left internal jugular vein
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